Healthcare Provider Details

I. General information

NPI: 1295867059
Provider Name (Legal Business Name): KIMBERLY DAVES ASHLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY DENISE DAVES

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 VERDAE BLVD
GREENVILLE SC
29607-4025
US

IV. Provider business mailing address

703 VERDAE BLVD
GREENVILLE SC
29607-4025
US

V. Phone/Fax

Practice location:
  • Phone: 864-288-6402
  • Fax: 864-234-7961
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27900
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: